Eligibility Framework for Children with Disabilities

1. Introduction

This guidance document supplements Peterborough's Thresholds to Intervention document and seeks to provide additional information and guidance about the services for Children with Disabilities (CWD) and should be read in conjunction with it. This guidance should also be read alongside the 'Eligibility Criteria for Children with disabilities' flowchart document.

This supplementary guidance is provided, because disabled children are children in need in law and this document sets out which children and young people are eligible for an assessment to establish whether additional support and services should be provided through the Children with Disabilities Service (CWD).

Each case is considered individually and this guidance is intended to help practitioners and families arrive at a decision about fair and equal access to services that ensure no child with a disability is disadvantaged because of their disability or home circumstances compared to any other child without a disability.

The Children With Disabilities Service (CWD) sits within the Children's Social Care Services based in Bayard Place. The CWD team provide assessment and access to a range of services for children with disabilities, their parents/carers, which meet the threshold criteria for referral. Following an assessment a range of services may be offered according to the needs identified.

Specialist Transition Workers from Adult Services work alongside the CWD team, to provide additional support to young people at such a significant time in their lives. The assessments made when the young person is moving on to adulthood and adult services, will endeavour to take account of the young person's developing capabilities, wishes and feelings, so that there will be a smooth transition.

The CWD team works closely with the Commissioning Service and, where appropriate, partner agencies in the health and education fields, to provide complex packages of support and/or care for children with disabilities.

Those disabled children not deemed eligible for a service from CWD's, may be entitled to access other services, such as short breaks available to all disabled children through the locally commissioned Short Breaks programmes formally known as Aiming High for Disabled Children programmes.

This guidance also covers the legal status of children who are provided with overnight short breaks. The approach is consistent with that suggested in the Statutory Guidance issued in March 2010 (Short Breaks: Statutory Guidance on how to promote and safeguard the welfare of disabled children using short breaks).

2. Which Children are Eligible for Children With Disabilities Services (CWD)?

The starting point for determining eligibility is the definition of disability set out in section 17(11) of the Children Act 1989. This states:

'a child is disabled if he is blind, deaf or dumb, or suffers from mental disorder of any kind or is substantially and permanently handicapped by illness, injury or congenital deformity or such other disability as may be prescribed'.

The Disability Discrimination Act 1995 used a wider definition of disability:

'1 Meaning of "disability" and "disabled person".

(1)Subject to the provisions of Schedule 1, a person has a disability for the purposes of this Act if he has a physical or mental impairment which has a substantial and long-term adverse effect on his ability to carry out normal day-to-day activities.'

3. Assessment and Support Packages

Disabled children are regarded as Children in Need and as such are entitled to a Child and Family Assessment of need, by a social worker. More details of the Assessment can be found in Peterborough's Thresholds to Intervention document.

Depending on the level of need there will be a range of services and support that can be provided. For those children with minimal additional needs, which can be met through community-based services, it is likely that the CWDs Service will provide advice and refer the case to an appropriate provider, Aiming High for Disabled Children short break services and/or the Multi-Agency Allocation Groups (MAAG's) or the Children With Disabilities panel. The case will then be closed to the CWD's service.

For those with significant additional, complex and acute needs, a Child and Family Assessment may be undertaken to identify appropriate resources and the amount of resource required. The purpose of the resources is to meet these additional difficulties and not to provide or replace either something the family would normally do, e.g. clean the home; or where a service in the community e.g. an after-school club, is already available.

There will be some personal preferences about how the resources are designed and delivered, to meet the child's assessed needs. For example: children may not want to stay overnight for a short break in a children's home, but would enjoy going out to access activities in the community with a support worker; or the child and his parents might like one or two nights overnight care for their child a month while others prefer a week away once a year to spend quality time with the other children in the family.

There are two main ways service can be provided to those children and their families who have additional assessed needs:

• Direct provision of services by or on behalf of the local authority;
• Through a Direct Payment, where the family decides the best way to use the budget available to them and directly employs people to provide those services or buys them from an existing provider.

4. Peterborough City Council Disability Services

Cherry Lodge and The Manor

There are two residential and short break (respite) units Cherry Lodge and The Manor. They provide overnight care, home support and day care for children and young people with disabilities within a 5-18 age range.

The LINK service which provides short breaks within a home setting by skilled and trained carers is managed by Cherry Lodge and co-ordinates family based opportunities for short breaks with retained carers.

5. The Legal Status of Short Breaks

In March 2010, the Government issued Statutory Guidance (Short Breaks: Statutory Guidance on how to safeguard and promote the welfare of disabled children using short breaks - DCFS - March 2010) to help local authorities to decide whether short breaks should be provided under s17 or s20 of the Children Act 1989.

Previously, some local authorities accommodated almost all children under s20 and as such they became 'looked after' by the local authority, while they received short breaks. Some parents and young people saw this as an intrusion into family life and many felt stigmatised as a result. Others treated almost all as s17 and as a result some important safeguards for the child, such as the case being reviewed independently, were lost.

The Guidance set out factors to be taken into account when making the s17/s20 decision (paragraph 2.8) and these are explained here:

Over time the circumstances of the child and family may change. For example a child whose family found it very difficult to cope with challenging behaviour, might receive short breaks under s20, because they need the local authority to help them look after their child, when they are at the short break provision; but if the challenging behaviour subsides over time and the family's capacity to cope increases, they may then be able to retain responsibility for their child while they are receiving a short break. Under this circumstance a review might decide to recommend a change in the legal status to s17.

Where the short break is provided under s.17, the suitability of the provision of short breaks or the amount or type of short break provided will still be reviewed, as part of the regular reviews of the Child in Need Plan every three months. The legal status of the placement will be considered at each review and should a decision be made to alter the legal status to s20 an Independent Reviewing Officer will be appointed and a first review held by the Independent Reviewing Officer within 20 days of the start of the first placement being made.

Locally, when a child is referred to the CWD Panel and Short Break provision is agreed, the legal status of the child will be confirmed by the panel who will have considered the guidance and ten key questions included below, as part of the needs assessment:

The ten key questions to consider when making a decision:

• Particular vulnerabilities of the child, including communication method;
• Parenting capacity of the parents within their family and environmental context;
• Wider family and environmental factors;
• The length of time away from home and the frequency of such stays; the less time the child spends away from home the more likely it is to be appropriate to provide accommodation under section 17(6);
• Whether short breaks are to be provided in more than one place; where the child spends short breaks in different settings, including residential schools, hospices and social care placements, it is more likely to be appropriate to provide accommodation under section 20(4);
• Potential impact on the child's place in the family and on primary attachments;
• Observation of the child (especially children who do not communicate verbally) during or immediately after the break by a person familiar with the mood and behaviour of the child (for example the parent or school staff);
• Views of the child and views of parents; some children and parents may be reassured by, and in favour of, the status of a looked after child, while others may resent the implications and associations of looked after status;
• Extent of contact between short break carers and family and between the child and family during the placement;
• Distance from home and the need for an Independent Reviewing Officer (IRO) to monitor the child's case and to chair reviews.

In relation to the legal status of short breaks table, PCC would expect some of the 10 questions to have significance (6.8 of The Children Act, Vol 2: Care Planning, Placement and Case Review does not state that all ten questions would be need to be of significance, when assessing children and young people).

Note: "If the accommodation is provided under section 20(4) for a continuous period of more than 24 hours, then the child is looked after by the local authority for the period in which the child is accommodated. If the child is placed for a weekend short break which lasts from Saturday morning until Sunday evening, this should count as two placement days." Paragraph 2.14 statutory guidance.

In addition, Peterborough's local approach would not necessarily regard overnight provision from school and returning to school the following day as a period of 24 hours, when considering calculations of Short Break periods.

6. Duty to make Provision

Short Breaks provide opportunities for children and young people with disabilities to spend time away from parents and carers within quality services. Short Breaks also provide parents and carers with breaks from their caring responsibilities, and facilitate quality of life by enabling families to access places and activities together.

The aim is to make sure that families with children with disabilities have access to appropriate short break opportunities, so that families can experience the same quality of life as those who do not live with disability. All families are different in that they will need different levels of support and different types of short breaks depending on the needs of the family, in relation to the ages and development of the children and young people and family circumstances.

This is underpinned by the law and shown in the legislation described below:

In performing their duty under paragraph 6(1) (c) of Schedule 2 to the Children Act 1989 Act (3), a local authority must:

1. Have regard to the needs of those carers who would be unable to continue to provide care unless breaks from caring were given to them; and
2. Have regard to the needs of those carers who would be able to provide care for their disabled child more effectively if breaks from caring were given to them to allow them to:
   1. Undertake education, training or any regular leisure activity,
   2. Meet the needs of other children in the family more effectively; or
   3. Carry out day to day tasks which they must perform in order to run their household.

7. Types of Service Which Must be Provided

In performing their duty under paragraph 6(1)(c) of Schedule 2 to the 1989 Act, a local authority must provide, so far as is reasonably practicable, a range of services which is sufficient to assist carers to continue to provide care or to do so more effectively.

In particular, the local authority must provide, as appropriate, a range of:

1. Day-time care in the homes of disabled children or elsewhere;
2. Overnight care in the homes of disabled children or elsewhere;
3. Educational or leisure activities for disabled children outside their homes; and
4. Services available to assist carers in the evenings, at weekends and during the school holidays.

8. Assessment Processes

Assessments are the process by which the Local Authority gathers together information about children and families, so that they can help make decisions about what support and interventions families might need and be entitled to.

An example of an assessment used formally within the Local Authority is the Common Assessment framework (CAF), carried out by a lead professional who works with the family. Other examples are Child and Family Assessments, carried out by social workers.

The Peterborough Threshold to Intervention document sets out definitions and indicators for practitioners to assist in the identification of levels of need for children and young people and should be read in conjunction with this guidance. The assessment processes described within the threshold document relate directly to four levels of need. Children with disabilities may meet the criteria for assessment within levels 2 - 4. In Appendix 1: Eligibility Criteria for Children with Disabilities we have detailed the types of services likely to be available to children with disabilities at the different levels.

Children at the Level 2 threshold - children in need of early intervention, will have emerging needs and these will be most commonly accessed using the CAF assessment process and may involve multi-agency coordination by a lead agency.   

Children at the Level 3 threshold - children with complex needs, are in need of targeted services above those available from universal services. The assessment process to access these services is likely to be either through the CAF process or a statutory process, such as a Child and Family Assessment and may involve multi-agency coordination by a lead statutory agency.

Children at Level 4 threshold - children with acute specialist needs, are in need of specialist services. These are a smaller group of children and young people who require intensive help and support to meet their needs. Children and young people will access specialist services following a statutory assessment.

Access to Resources

In Peterborough we are developing a broad range of services to meet the needs of children and families; we are committed to supporting children and young people to be able to remain living in their families and local communities and reducing the need for specialist interventions by intervening early and preventing difficulties and problems escalating.

• The Multi-Agency Support Groups (MASG): The MASG consists of local providers that meet on a fortnightly basis in three localities and include representatives from:
  • Social Work;
  • Educational Psychology;
  • Education Attendance Service;
  • CAMHs;
  • Primary Health Care Workers;
  • Youth Work;
  • CAF Co-ordinators;
  • Youth Offending;
  • Connecting Families;
  • Police;
  • Commissioners;
  • Private Sector;
  • Voluntary Sector;
  • Independent Sector;
  • The panel is school and community facing and aims to provide early interventions that are seamless and timely. Linked to the development of the MASG will be the continued roll out of the Common Assessment Framework, Teams around the Child/Family and Lead Professional Role, supported by the CAF Co-ordinators. The MASG are organised by the Peterborough Children's Services Commissioning Function.
• The Peterborough Access to Support Panel (PASP): The PASP consists of Education and Social Care professionals and is supported by the Commissioning Function, it meets weekly on a Tuesday (apart from the last Tuesday in the month) and is responsible for agreeing high level family support, therapeutic and education packages of support as an alternative to accommodating children, school exclusion; care, education and criminal justice proceedings. All allocations of service provision are reviewed on a regular basis to ensure desired outcomes are being met;
• The Peterborough Joint Agency Support Panel (PJASP): The PJASP consists of Education and Children's and Adult Social Care professionals and Health professionals, it is organised by the Peterborough Children's Services Commissioning Function. The panel meets on the last Tuesday of every month and agrees joint resource allocation for accommodation or support packages for children and young people with complex and challenging needs. All service provision is regularly reviewed to ensure the desired outcomes are met;
• The Peterborough Children with Disabilities (CWD) Panel: The CWD panel is a multi-agency panel consisting of representatives from:
  • Health;
  • Children's Social Care;
  • Adult Social Care;
  • Education;
  • Commissioning professionals;
  • It is organised by Peterborough Children's Commissioning Function. The panel meets monthly and agrees support packages for children with disabilities through a range of short break options or direct payments. All service provision is regularly reviewed to ensure the desired outcome is met for disabled children.
• The Statutory Assessment Panel: consists of professionals representing Education, Early Years, and Health. This panel meets monthly on Thursdays to consider referrals for statutory assessment and also refers to PASP, JASP and CWD panel where there is concern that evidence submitted shows that a child/young person's needs are wider than educational. The aim is to have referrals made via the CAF with detailed professional reports as appendices.

Transition

Specialist Transition Workers from Adult Services work alongside the Children with Disabilities Social Workers, to provide additional support to young people at such a significant time in their lives. The assessments made when the young person is moving on to adulthood and adult services, will take account of the young person's developing capabilities, wishes and feelings, so that there will be a smooth transition.

The aim of the Transitions Team is to improve the planning for the transition of young people to adult services by:

• Improving the information available at an early stage in the process;
• To manage the process more effectively by early identification of needs and aspirations;
• To better manage future services by working with young people, their families and carers, and their social work and educational advisors, so that their longer term developmental and support needs are considered at an earlier stage;
• To manage moves in a more open and equitable manner.

Advocacy

NYAS advocacy services provide children and young people with information about their rights and entitlements and assistance to enable them to use formal complaints procedures if that is what they want, and to have a voice and be heard when decisions are made about their lives.

Appendix 1: Eligibility Criteria for Children with Disabilities

Click here to view Appendix 1: Eligibility Criteria for Children with Disabilities.

Appendix 2: Peterborough Short Breaks Local Offer

Click here to view Appendix 2: Peterborough Short Breaks Local Offer.

Appendix 3: Cambridgeshire Short Breaks Local Offer

Click here to view Appendix 3: Cambridgeshire Short Breaks Local Offer.